HomeMy WebLinkAbout1020 ~ecla~ation of Dumicile aed Cltisenship ~
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TO THE STATE AND GOUNTY TAX ASSESSOR, '
Sl. LUCIE COUNTY, FLORIDA:
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This is my declarotion of Domicile and Citizenship in the State of Florida that I am filin~ this d~l in aoootdar~ and
in conformity with Chapte~ 222, Sectio~ 222.17. Florida Statutes.
I was formerly a legal residenr of ____~instoa _ No. Larolina
(City)
and 1 resided at 902_ParrOt t Ave . Howe„er ~ t,a~?e ch.r~d ~n~r donrci~e
(Street and Number)
to and am and have been a bona fide resident of the State of Flo?ida sinoe lst
March _ , 19 66 ~ and 1 ~eside at 430 Pri~ta Vista B1v~L
(Shreat u~d t~knr+be~
FORT PIERCE, SAINT LUCIE COUNTY, RORIDA
and this statement is to be taken as my declaration of citizenship, actual legal residenoe and domicile in the State of Horida.
(Insert here any pertinent facts, such as sale of property orbusineu, orteiinquisMnent of empfoyment
at former domicile, removal of family to ~ew domicile, purchase of hane, etc.)
~ntering child in school ~
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I FURTHER CERTIFY that I will oomply with all other requirements of a le~al rasidsM o# this S~le.
,;,ii~6URT1{ER CERTIFY that I have no intention to return to my former domicile, and I intend to r~anain in iORT
ti~• . -c • .
PI~R~E;:$,p?IN~:.4~1~1~=COUNTY, FLORIDA, per~ianently.
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. ~ . -j, ~ ~ ~ _ Oliver
H.~~ derson~
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2 ,~Hay 66
Sworn to end subsuibed before me this day of 19
4,
ROGER PORRAS
Q~ IT C URT Notary Public
By ~ O.C. My Commiuion expiros
Qo b~ ~acuhd in d~eplicsf~ and ori~inal fil~d whh CIKk Girarif CaKt, and drp~icalr ~rii Taac A~~~,l
gooK 144 _ 4~.8
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